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Cancer du sein: l’homme est aussi concerné. Étude de 21 cas

Breast cancer: male is also concerned. Report on 21 cases

Résumé

Introduction

Le cancer du sein, première pathologie maligne chez la femme, reste une maladie rare chez l’homme. Il représente environ 1 % des cancers du sein et moins de 1 % de l’ensemble des néoplasies masculines. L’objectif de cette étude est d’analyser les caractéristiques cliniques, histologiques et thérapeutiques du cancer du sein chez l’homme.

Patients et méthodes

Les auteurs présentent une étude descriptive menée de manière rétrospective au service de radiothérapie-oncologie du CHU Ibn-Rochd de Casablanca, entre janvier 2006 et décembre 2007, concernant une série de 21 patients de sexe masculin présentant un cancer du sein.

Résultats

L’âge médian était de 70 ans (extrêmes: 39–84). Le délai médian de consultation était de huit mois (extrêmes: 2–24). Il s’agissait, dans 16 cas, d’une tumeur rétroaréolaire dont la taille médiane était de 35 mm (extrêmes: 15–80). Les tumeurs étaient classées T2 dans 12 cas et T4 dans sept cas. Le type histologique le plus représenté était le carcinome canalaire infiltrant (CCI) [18 cas]. Le grade SBR II a été retrouvé dans 13 cas. Le taux d’envahissement ganglionnaire axillaire prouvé histologiquement était de 38 % (huit patients) et dans 14 % des cas plus de trois ganglions étaient envahis. L’effraction capsulaire n’a été retrouvée que dans quatre cas. Les récepteurs hormonaux étaient positifs dans 19 cas. La prise en charge thérapeutique a consisté en une chirurgie radicale dans 14 cas avec une chimiothérapie associée à une radiothérapie dans cinq cas, 66 % des patients ont reçu une hormonothérapie. Après un suivi moyen de 23 mois, trois malades ont développé des métastases et six malades sont encore vivants sans maladie.

Conclusion

Le cancer du sein chez l’homme est rare. Son diagnostic se fait souvent à un stade tardif. Son traitement est similaire à celui de la femme avec un retard diagnostique retentissant sur le pronostic.

Abstract

Introduction

Breast cancer, the primary malignancy in women, is a rare disease in men. It represents approximately 1% of breast cancers and less than 1% of all malignancies affecting men. The aim of this study is to analyze the clinical, histological and therapeutic features of breast cancer in men.

Patients and methods

The authors present a descriptive retrospective study conducted in the radiotherapy-oncologydepartment of Casablanca, from January 2006 to December 2007. Twenty-one cases of male breast cancer were studied.

Results

The median age was 70 years (range: 39–84). The median time of consultation was 8 months (range: 2–24). The tumor was subareolar in 16 cases and the median size was 35 mm (range: 15–80). Tumors were classified as T2 in 12 cases and T4 in 7 cases. The most reported histological type was invasive ductal carcinoma (18 cases). Grade II SBR was found in 13 cases. The rate of histologically proven axillary lymph node involvement was 38% (8 patients), and in 14% of cases, more than three lymph nodes were involved. Hormone receptors were positive in 19 cases. Treatment consisted of radical surgery (mastectomy and axillary lymph node dissection) in 14 patients, with chemotherapy combined with radiotherapy in 5 cases, while 66% of patients received hormone therapy. After a median follow up of 23 months, three patients developed metastases and six patients are still alive without disease.

Conclusion

Breast cancer in men is rare. It is often diagnosed at a late stage. Its treatment is similar to the treatment for women’s breast cancer but with a diagnosis delay, which affects the prognosis.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Sellal, N., Haddad, H., Bouchbika, Z. et al. Cancer du sein: l’homme est aussi concerné. Étude de 21 cas. Basic Clin. Androl. 21, 45–51 (2011). https://doi.org/10.1007/s12610-010-0116-x

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